Provider Demographics
NPI:1548276538
Name:JARVIS, VINCENT N
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:N
Last Name:JARVIS
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:VINCENT
Other - Middle Name:NATHAN
Other - Last Name:JARVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:141 5TH AVE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7105
Mailing Address - Country:US
Mailing Address - Phone:212-533-2400
Mailing Address - Fax:
Practice Address - Street 1:141 5TH AVE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7105
Practice Address - Country:US
Practice Address - Phone:212-533-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165969207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine